There is growing recognition among public health circles of the need for regulatory action for overweight and obesity, but there has been limited research into whether the Australian public supports ...government intervention. This study aimed to determine the level of public support for food-related regulations for obesity, and to assess the determinants of support.
A nationally representative sample of Australian adults (n = 2011) was recruited by market research company Online Research Unit to complete an online survey. The survey measured respondents' perception of the obesity problem in Australia, and level of agreement on a 5-point Likert scale (strongly disagree to strongly agree) with proposed regulations in three domains; advertising, sponsorship of children's sport, and taxation. Binary logistic regression models were run to examine the association between demographic variables and support for regulation.
The majority of respondents (92.5%) considered overweight and obesity to be a somewhat or very serious problem in Australia, and almost 90% felt there should be at least some government regulation to protect the public. Respondents agreed that the government should regulate food and beverage advertising (69.5%), with strongest support for restricting unhealthy food advertising to children (78.9%). There was lower support for prohibiting unhealthy food and beverage company sponsorship of children's sport (63.4% agreement), and for taxing sugar-sweetened beverages (54.5%), although the majority were still in favour. Support for fiscal policies slightly increased if revenue was to be used for health purposes. Females and tertiary educated respondents showed stronger agreement with proposed regulations (p < 0.05).
The survey findings suggest the majority of the Australian population recognises obesity to be a serious health problem, and support government regulation of the food environment as a population-level preventative strategy.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Increased marketing of energy-dense, nutrient-poor foods has been identified as a driver of the global obesity epidemic and a priority area for preventative efforts. Local and international research ...has focused on the unhealthiness of television advertising, with limited research into the growing outdoor advertising industry. This study aimed to examine the extent of food and beverage advertising on the Sydney metropolitan train network, and to assess the nutritional quality of advertised products against the Australian Guide to Healthy Eating.
All 178 train stations on the Sydney metropolitan train network were surveyed in summer and winter. A survey tool was developed to collect information for all advertisements on and immediately surrounding the train station. Information included product, brand, location and advertisement format. Advertisements were coded by nutrition category, product subcategory and size. Chi-square, ANOVA and ANCOVA tests were conducted to test for differences in the amount of food and beverage advertising by season and area socioeconomic status (SES).
Of 6931 advertisements identified, 1915 (27.6%) were promoting a food or beverage. The majority of food and beverage advertisements were for unhealthy products; 84.3% were classified as discretionary, 8.0% core and 7.6% miscellaneous. Snack foods and sugar-sweetened beverages were the most frequently advertised products, regardless of season. Coca-Cola and PepsiCo were the largest advertisers on the network, contributing 10.9% and 6.5% of total advertisements respectively. There was no difference in the mean number of food and beverage advertisements by area SES, but the proportion of advertising that was for discretionary foods was highest in low SES areas (41.9%, p < 0.001).
The results indicate that, irrespective of season, food and beverage advertisements across the Sydney metropolitan train network are overwhelmingly for unhealthy (discretionary) products. The results of this study highlight the inadequacy of Australia's voluntary self-regulatory system in protecting members of the public from exposure to unhealthy food advertising. Regulatory action by government, such as placing a cap on the amount of unhealthy food advertisements, or requiring a proportion of all advertising to be for the promotion of healthy foods, is required to address this issue.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Carbohydrate-restricted diets produce greater reductions in HbA1c over 3–6 months.•The effects are primarily driven by low carbohydrate diets (<26% of total energy).•Both diets showed declining ...effectiveness over the longer-term (12–24 months).
Nutrition therapy is considered a key component of diabetes management, yet evidence around the ideal macronutrient composition of the diet remains inconclusive. A systematic review and meta-analysis was performed to assess the effects of carbohydrate-restricted diets (≤45% of total energy) compared to high carbohydrate diets (>45% of total energy) on glycemic control in adults with diabetes mellitus. Six databases were searched for articles published between January 1980 and August 2016. Primary outcome was between-group difference in HbA1c change. Individual effect sizes were standardized, and a meta-analysis performed to calculate pooled effect size using random effects. 25 RCTs involving 2412 participants were included. Carbohydrate-restricted diets, in particular those that restrict carbohydrate to <26% of total energy, produced greater reductions in HbA1c at 3 months (WMD −0.47%, 95% CI: −0.71, −0.23) and 6 months (WMD −0.36%, 95% CI: −0.62, −0.09), with no significant difference at 12 or 24 months. There was no difference between moderately restricted (26–45% of total energy) and high carbohydrate diets at any time point. Although there are issues with the quality of the evidence, this review suggests that carbohydrate-restricted diets could be offered to people living with diabetes as part of an individualised management plan.
The Rule of Halves (ROH) is a theoretical framework which states that roughly half of all people with a condition are diagnosed; half of those diagnosed receive care; half of those who receive care ...achieve their treatment targets; and half of those who reach their targets achieve the desired treatment outcomes. This review examined the applicability of the ROH to diabetes in Australia. Five databases were searched for articles and government reports published between January 2000 and August 2019. Data was extracted for each level of the framework, and pooled sample proportions calculated for the total population and sub-group analysis by ethnicity and type of diabetes. The results showed that 72% of people with diabetes are diagnosed. Approximately 50% are receiving standard care, and 40–60% are meeting treatment targets for HbA1c, blood pressure and lipid levels. Overall, Australia is doing better than the ROH when it comes to achieving treatment outcomes; prevalence of microvascular complications was 20–30% and cardiovascular disease 62%. Indigenous people were less likely to meet treatment targets and more likely to experience adverse complications of diabetes. This review indicates the ROH does generally apply for diabetes care and management in Australia, highlighting the need for further improvement.
•Australia is a substantial way from implementing a sugar-sweetened beverages tax.•Industry interference, fragmented advocacy and conflicting political agendas have undermined tax ...acceptance.•Advocates should re-frame the problem to which the tax has been coupled.•A broader advocacy base is needed to counter industry power.
Globally, 43 jurisdictions have implemented a tax on sugar-sweetened beverages (SSBs) for obesity prevention; however, there is significant political resistance to adopting such a policy in Australia. This paper applies Kingdon’s Multiple Streams Framework (MSF) to the case study of an SSB tax in Australia to identify barriers and enablers to policy adoption, and to inform future advocacy strategies in local and international contexts. A systematic search was conducted of scholarly literature, parliamentary documents and media articles relating to an SSB tax. Information retrieved was analysed and integrated under the ‘problem’, ‘policy’ or ‘political’ streams of the MSF. The findings reveal that Australia is a substantial way from having the conditions in place where a tax might be successfully implemented due to industry influence, fragmented advocacy efforts, political opposition to paternalistic policies, conflicting political agendas, and inadequate pressure for change from civil society. Opening a policy window will require a shift in political ownership of the obesity problem, or the coupling of an SSB tax to an alternative problem. The public health community also needs to agree that an SSB tax deserves greater priority, relative to alternative policies for addressing obesity, and to agree on the most effective tax design.
There is an urgent need to identify and develop cross-sectoral policies which promote and support a healthy, safe and sustainable food system. To help shape the political agenda, a critical first ...step is a shared definition of such a system among policy makers across relevant sectors. The aim of the present study was to determine how Australian policy actors define, and contribute to, a healthy, safe and sustainable food system.
A Delphi survey, consisting of two rounds, was conducted. Participants were asked how they define, and contribute to, a healthy, safe and sustainable food system (Round 1) and indicate their level of agreement with summary statements (Round 2).
This was an online Delphi survey conducted in Australia.
Twenty-nine and fourteen multisectoral and multilevel policy makers completed Round 1 and Round 2, respectively.
The definition included food processing regulation, environmentally friendly food production and access to nutritious food. All agreed that it was important for them to improve access and supply of healthy food and ensure healthy planning principles are applied.
There were cross-sectoral differences in definitions and contributions; however, critical consensus was achieved. The study contributes to the definition of key elements of a cross-sectoral food and nutrition policy to meet today's environmental, health, social and economic challenges; however, further research using a more representative multisectoral sample is warranted.
Summary
Food accessibility was considerably impacted by restrictions during the coronavirus disease 2019 (COVID‐19) pandemic, leading to growth in the online food retail sector, which offered ...contact‐free delivery. This systematic review aimed to assess the change in use of online food retail platforms during COVID‐19. The secondary aim was to identify diet‐related chronic disease risk factors including dietary intake, eating behaviors, and/or weight status associated with the use of online food retail platforms during the pandemic. The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022320498) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Nine electronic databases were searched between January 2020 and October 2023. Studies that reported the frequency or change in use of online groceries, meal delivery applications, and/or meal‐kit delivery services before and during the pandemic were included. A total of 53 studies were identified, including 46 cross‐sectional studies, 4 qualitative studies, 2 longitudinal cohort studies, and 1 mixed‐methods study. Overall, 96% (43/45) of outcomes showed an increase in the use of online groceries during COVID‐19, while 55% (22/40) of outcomes showed a decrease in meal delivery applications. Eight of nine outcomes associated the use of online food retail with weight gain and emotional eating. Further research is needed to investigate the links between online food retail and obesity.
Objective:
The objectives of this study were to (1) measure the acceptability of Students As LifeStyle Activists (SALSA) Youth Voices (SYV) programme, (2) determine the skills gained by peer leaders ...from their participation in SYV and (3) determine whether peer leaders were able to design and implement an action to promote healthy eating and physical activity in their school.
Design:
Process evaluation.
Setting:
Peer leaders (aged 15–16 years) from high schools in Western Sydney, Australia.
Method:
We conducted a process evaluation to determine the reasons why students participated in SYV, which workshop activities they enjoyed, the skills they gained from participating in SYV and whether the actions were designed and implemented. Peer leaders completed an online survey at the end of the Leadership Day. The peer leaders then presented their actions at an SYV Action Day event and completed a further online survey.
Results:
Eighty-four peer leaders from seven high schools in Western Sydney participated in SYV. Peer leaders reported their involvement with the SYV programme as positive, with 68% rating it as ‘very valuable’. Skills gained by the peer leaders included teamwork (90%), communication (85%), leadership (77%) and confidence (65%). Peer leaders planned and devised actions, which included installing water refill stations, fitting the school gymnasium with new equipment, redesigning girls’ sports shorts, and other strategies to engage girls in physical activity. Students from all seven schools presented their actions to receive feedback and expressed confidence that their actions were sustainable.
Conclusion:
The SYV programme showed that providing peer leaders with ownership of their actions was successful in creating healthy school environments, while building leadership, teamwork, communication skills and confidence in adolescents.
C-peptide is a widely used measure of pancreatic beta cell function. It is produced in equimolar amounts to endogenous insulin but is excreted at a more constant rate over a longer time. Methods of ...estimation include urinary and unstimulated and stimulated serum sampling. Modern assays detect levels of c-peptide which can be used to guide diabetes diagnosis and management. We explore the evidence behind the various tests available. We recommend the glucagon stimulation c-peptide testing owing to its balance of sensitivity and practicality. C-peptide levels are associated with diabetes type and duration of disease. Specifically a c-peptide level of less than 0.2 nmol/l is associated with a diagnosis of type 1 diabetes mellitus (T1DM). C-peptide level may correlate with microvascular and macrovascular complications and future use of insulin therapy, as well as likely response to other individual therapies. We explore the potential uses of c-peptide measurement in clinical practice.
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